Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic

Deanna Kerrigan, Jonathan M. Ellen, Luis Moreno, Santo Rosario, Joanne Katz, David D. Celentano, Michael Sweat

Research output: Contribution to journalArticlepeer-review

151 Scopus citations


Objective: To examine the influence of environmental-structural factors in promoting consistent condom use (CCU) among female sex workers (FSW) and their regular paying partners in the Dominican Republic. Methods: A cross-sectional survey was conducted with 288 FSW recruited from 41 sex establishments in Santo Domingo from March to June 1998. Sex workers were asked about their sexual behavior, self-efficacy at negotiating safe sex, perceived intimacy with their most recent regular paying partner, and the physical, social and policy environment of the establishment where they worked. Factor and reliability analysis were utilized to develop aggregate measures for self-efficacy (Cronbach's Alpha 0.60), intimacy (Cronbach's Alpha 0.80), and environmental-structural support (Cronbach's Alpha 0.72). Results: Controlling for sociodemographic characteristics of participants in multivariate analyses, environmental-structural support for condom use and HIV/sexually transmitted infection (STI) prevention was a significant predictor of CCU (OR 2.16; CI 1.18-3.97) among FSW and their regular paying partners. Safe sex self-efficacy (OR 2.80; CI 1.31-5.97) and low perceived intimacy with the most recent regular paying partner (OR 7.20; CI 3.49-14.83) were also significantly associated with CCU in multivariate analysis. Conclusion: Environmental-structural support for condom use and HIV/STI prevention is a significant predictor of CCU among FSW in the context of regular paying partnerships. Environmental-structural factors, in addition to relational and individual cognitive factors, should be assessed and addressed by behaviorally guided theory, research and interventions related to HIV/STI prevention and female sex work.

Original languageEnglish (US)
Pages (from-to)415-423
Number of pages9
Issue number3
StatePublished - Feb 14 2003


  • Condom use
  • Dominican Republic
  • Environmental-structural factors
  • Female sex workers
  • Intimacy
  • Regular paying partners
  • Self-efficacy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


Dive into the research topics of 'Environmental-structural factors significantly associated with consistent condom use among female sex workers in the Dominican Republic'. Together they form a unique fingerprint.

Cite this